everywomanover29 blog

Food, Mood and Women's Health – Be your healthiest, look and feel great!

Proctalgia fugax

Fran suffered from proctalgia fugax alarmingly frequently for over 10 years: GABA is the only thing that helps and has absolutely changed her life

By Trudy Scott 4 Comments

proctalgia fugax and gaba

Trudy, your information about GABA has absolutely changed my life. I was suffering from proctalgia fugax alarmingly frequently over the last 10 + years, not just during the night but also during the day, at work, while driving, anywhere… which caused so much anxiety and stress for me. I had many episodes where I had vasovagal episodes and passed out (which instantly resolved the symptoms but left me exhausted and battered.)

Now, because of your information I have a strategy that seems to work almost all the time- I take half a teaspoon of GABA powder sublingually as soon as I feel the twinge coming on. I sit on the ground in a safe place where I can either slump left or right without hitting my head (seriously! ).

I open the “breathing app” on my phone (free app) and focus on breathing in time with the inflating and deflating ball on the screen . I have more powder if the symptoms are not fading. Reducing the panic by controlling my breath is absolutely crucial, and the GABA powder short cuts the whole episode.

In the past, before GABA, I have had episodes that lasted over an hour. I have small tubs of GABA stashed in my handbag, gym bag, office, car etc. This has been the only thing that helped. Thank you

Fran posted this wonderful feedback about how the amino acid GABA, used as a supplement, is life-changing for her proctalgia fugax. If, like Fran and I, you’ve experienced these anal cramps (or butt cramps or anal sphincter spasms or “cramps in your bottom”), I know you can relate to how intense the pain can often be.

Today’s blog highlights more about this condition in case proctalgia fugax is new to you or if this application of GABA is new to you. I also discuss GABA dosing and some insights that may help Fran (and her son) get even more relief. And I share some of the latest research which unfortunately doesn’t offer much in the way of a solution.

How much GABA does Fran use?

I thanked Fran for sharing her wonderful success using GABA for proctalgia fugax. And I acknowledged how stressful it is to not know when the next episode will happen and then to be in such pain for over an hour in some instances. Like Fran, I’ve had a few clients also report passing out due to the pain.

She mentions using “half a teaspoon of GABA powder sublingually” as soon as she feels the twinge coming on. The key here is use it as soon as you feel the twinge of pain and using it sublingually like Fran does is perfect. Half a teaspoon of the powder is around 1500 mg GABA, which is a very high dose (a typical starting dose is 125 mg GABA).

I first blogged about GABA as a solution for my agonizing rectal pain and spasms in 2017. I find that 125 mg to 250 mg GABA works well for my needs and have had similar feedback from others in the community. I share this to illustrate the variability in the amount that may help.

For Fran, increasing the amount of GABA may help with prevention. But given the high dose she is already using I suspect that as time goes on and her GABA levels increase, it’s possible that her need to sit on the ground and use the breathing app may no longer be needed. She may find her GABA levels rebound with consistent GABA use throughout the day, even when she is not experiencing rectal spasms.

She does also mention feelings of panic so it’s possible that low serotonin may also be a factor. If this is the case then a trial of tryptophan or 5-HTP is worth considering.

GABA helps Fran’s son too

Fran added this PS to her comment:

Ps my 21 yo son has started experiencing these symptoms recently and he follows the process of taking GABA and using the breathing app and hasn’t had an episode last longer than a few minutes. I am so grateful that he hasn’t experienced a full blown episode of proctalgia fugax.

How wonderful that this helps her son too!

For both of them, I’d recommend trying to figure out what may be contributing to their low GABA levels and addressing those root causes. My book is a great starting point to address dietary factors, gut health, low zinc, low vitamin B6, toxins and infections that may play a role.

What is proctalgia fugax pain like and how is it treated medically?

This recent paper, Chronic anal pain: A review of causes, diagnosis, and treatment shares that “chronic anal pain is a relatively common problem affecting up to 11.6% of the US population.” Proctalgia fugax is one type of chronic anal pain and in this paper the pain is described as follows:

  • “Short-lasting (seconds or minutes) sharp deep rectal stabbing or cramping. No radiation. No anorectal pain between episodes.
  • The pain can occur night or day and vary in severity from uncomfortable to unbearable.”

It’s really disappointing to me that the solution offered is simply reassurance and an explanation:

From a treatment perspective, the problem with diagnosing proctalgia fugax is that symptoms are generally too brief or infrequent to treat. Thus, the key is patient reassurance and explanation, such as describing the condition as a “cramp in your bottom” that is harmless and not indicative of any serious bowel disease.

It may be harmless but I’ve had clients describe the pain as excruciating and agonizing, with many saying it’s worse than childbirth.

As you read above, these episodes caused Fran “so much anxiety and stress”, caused her to pass out and left her feeling “exhausted and battered.” I don’t know what her medical team told her but I believe we can do better than what these authors are proposing.

The first time I experienced a proctalgia fugax episode, I was terrified and beside myself, not knowing what it was or what to do. The pain was extremely severe and lasted about an hour.  I eventually figured out the solution because I had used GABA for my own anxiety and to ease tense muscles and other kinds of pain.

GABA for anxiety, pain and muscle spasms (and more)

A number of studies have shown that “GABA is implicated in a large number of diseases including anxiety and stress disorders, pain, musculoskeletal disorders, sleep disorders, depression, addiction and withdrawal syndromes.”

It’s time that GABA supplementation is recognized and used more for pain, muscle spasms and anxiety – everything that Fran and her son experience. I’d love to get some cases like this published so we can get the message out in a bigger way and have the research catch up with what we are seeing clinically. If you know of anyone who could help in this regard please do comment below or reach out.  

A few GABA product options  – a sublingual, a powder and a cream

gaba calm
gaba pure poder
somnium gaba cream

Fran used a GABA powder, possibly similar to Now GABA Powder (which does need to be measured out to provide a 125 mg typical starting dose). Keep in mind, some individuals need less to start and some like Fran may need more.

When using GABA powder I have clients use a handy mini measuring spoon like this one (my Amazon link) and share more about how to measure out GABA powder on this blog).

Source Naturals GABA Calm lozenges (a good low dose of 125 mg) is another GABA product I recommend and is helpful in cases of proctalgia fugax because of the lozenge instead of it being a powder that needed to be measured.

For Source Naturals GABA Calm lozenges and Now GABA Powder:

Somnium GABA Cream used before bed may prevent an episode in the night and is less likely to stop an episode that is in full force. It is available in the US and elsewhere with international shipping. Read more about the product and who else may benefit from using a cream, and grab my coupon code to save 15%.

Additional resources when you are new to using GABA and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low low GABA or other neurotransmitter imbalances may be an issue.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control (this is covered in an entire chapter too), sugar cravings, anxiety and mood issues.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Wrapping up and your feedback

I appreciate Fran for sharing her success with GABA and the success her son has experienced too. I do hope this information has been helpful for you and for them too.

Now I’d love to hear from you – does any of this resonate with you? Have you had success like this with GABA? What solution has your medical team offered?

If you’re a practitioner is GABA one of the amino acids you use with your clients/patients?

Feel free to share and ask your questions below.

GABA lozenge relieves excruciating pelvic floor/rectal pain and spasms within 30 seconds: a solution for proctalgia fugax

By Trudy Scott 28 Comments

gaba lorenze

Have you experienced excruciating pain in the rectum as a result of spasms in your anal sphincter? You may not even know this condition is called proctalgia fugax and you may struggle with the agonizing pelvic floor pain with no quick solution. You may also not get much help from your doctor because the management of proctalgia fugax remains challenging.

The good news is that there is a simple solution that eases the spasms and stops the pain very quickly, typically in less than 2 minutes and sometimes as quickly as 30 seconds. Ashlee discovered how quickly a GABA lozenge worked to give her immediate relief from her scary and excruciatingly painful spasms.

Here is Ashlee’s wonderful feedback on the blog I wrote on this topic a few years ago after this started happening to me:

I want to personally thank you for this article and option of GABA to relieve the excruciating pain I was having.

After research I realized that my pelvic floor was having spasms. Such a new and scary feeling to have been having, and finding your advice and immediate relief of GABA changed everything!

Of course the scariest part initially is the pain and the “what is happening feeling!” But it’s quickly followed up with “when will this happen again, where will I be, and what do I do in that situation?”

I would highly recommend the GABA lozenges which I got at the vitamin store down the street. I carry them in a little baggie with me now just in case an episode happens. I did have an episode happen when I was on site of a job, and thankfully had the GABA lozenge to immediately relieve the pain, literally (within 30 seconds!! INCREDIBLE!)

The option otherwise (and what I did when it first happened) was to soak in a warm bath or with a heating pad, which obviously is not an option if you are at work or not at home.

The other options as suggested online are even scarier… resorting to electric shock up the rectum to ease the spasms! Yikes!

I thanked her for sharing how well the GABA lozenge works for her, saying how happy I am for her! I also let her know that I’d love to share it as a new blog post because it offers so much hope to others (hence this blog).

GABA Calm lozenge and other low GABA symptoms

I assume Ashlee is referring to Source Naturals GABA Calm lozenges which contains 125mg of GABA and is a sublingual lozenge. They do really work this quickly for spasms, pain and anxiety too. GABA always works best when used in a sublingual form like this or when a GABA capsule is opened onto the tongue.

I agree with her – it’s a good plan to keep GABA on hand in case she gets the spasms during the day. I also recommend having GABA next to the bed because it often seems to happen in the middle of the night.

I did ask if using GABA has also helped with easing her other low GABA symptoms. These can include:

  • physical anxiety and overwhelm
  • intrusive thoughts
  • stiff and tense muscles or other muscle spasms/pain
  • insomnia (often the type where you lie awake feeling stiff and tense)
  • stress eating carbs or sugary treats
  • self-medicating with wine or other alcoholic beverages in order to relax and fit in

You can see the entire list of low GABA symptoms here.

(I’ll share an update when I hear back from Ashlee.)

My experience, definition of proctalgia fugax, incidence and overview

I acknowledged her comment about it being very scary the first time it happens. I first blogged about this after it happened to me in 2017 and I figured out GABA worked very quickly for my excruciatingly painful spasms. It was really scary!

You can read about my experience and triggers on this blog: How GABA eases agonizing rectal pain and spasms in under 2 minutes.

The above blog also

  • defines this condition called proctalgia fugax which leads to rectal spasms and sharp fleeting pain in the lower rectum or anus. In some people it can be more than fleeting and is often described as excruciating and agonizing
  • shares how others describe the pain and how common it is (up to 18% of the population, more common in women and affects individuals between 30 and 60 years of age).
  • discusses heating pads as a solution (they also work but can take 20 minutes to take effect and that is simply too long when you are moaning and writhing in pain)
  • mentions medications that are commonly prescribed
  • describes using 30-60 seconds of finger pressure as one possible solution
  • reviews the BEST solution – sublingual GABA. Theanine and taurine can also help

Electrical stimulation of the anorectal muscles or botox – as treatment approaches

When I had first researched this a few years ago, I had not read about “electric shock up the rectum to ease the spasms” that Ashlee mentioned in her comment.  I went looking and found this on Webmd:

For severe proctalgia fugax, electrical stimulation of the anorectal muscles may provide relief. This treatment option involves inserting a small, finger-sized probe into the rectum and using a low voltage current to relax spastic muscles through vibration.

This may be similar to the 30-60 seconds on finger pressure I described but I’ll take the GABA supplement thank you!

This article also mentions botox injections which I am aware is often done. But this opens up another whole can of worms with toxicity issues and the risk of increased panic attacks with botox.

I also share additional information here: How to address rectal spasms with GABA, pelvic floor work, gluten removal and squats

Management of proctalgia fugax remains challenging and treatment outcomes modest at best

A paper, Proctalgia Syndromes: Update in Diagnosis and Management, published June 2020 by gastroenterology departments in Ireland, Romania, Italy and the USA recognizes that “functional anorectal pain syndromes” are complicated and “are a neglected yet often disabling clinical entity resulting in significant economic and psychological burden to the patient.”

They acknowledge that “management of proctalgia fugax remains challenging and treatment outcomes modest at best” and conclude that “further investigation of treatment approaches in proctalgia fugax is required.”

I plan to reach out to the authors and share these wonderful results that individuals are reporting with the use of sublingual GABA. I would also love to get some case studies published so this approach becomes common knowledge.

Resources if you are new to using GABA and the amino acids as supplements

If you are new to using the amino acids GABA and the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low GABA or low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acid products that I use with my individual clients and those in my group programs.

Have you ever experienced this rectal pain and spasms/proctalgia fugax? Has GABA worked for you? What else has helped?

If GABA helped ease the spasms and pain, how quickly did it work and what product did you use? Did it help with some of the other low GABA symptoms too?

Have you been able to figure out possible triggers or root causes other than low GABA?

If you’re a practitioner, have you seen this with clients or patients and has GABA helped them?

Feel free to ask your questions here too.

GABA for bladder pain/interstitial cystitis and urgency, IBS pain and anxiety?

By Trudy Scott 19 Comments

gaba for pain

Is there a place for using the amino acid GABA as a supplement to help with bladder pain/interstitial cystitis and urgency and also help with IBS (irritable bowel syndrome) pain – at the same time as easing physical anxiety caused by low GABA levels?

I’d like to share some quotes from this commentary, GABAB receptors in the bladder and bowel: therapeutic potential for positive allosteric modulators?

The bladder pain syndrome (or interstitial cystitis/painful bladder syndrome) is a spectrum of urological symptoms characterized by frequency, urgency and pain on bladder filling.

Bladder pain syndrome is often present in those who have IBS and abdominal pain and the authors mention the role of GABA in both:

Of further note is the co-morbidity between bladder pain syndrome and other functional pain syndromes, in particular, irritable bowel syndrome, a functional gastrointestinal disorder associated with visceral abdominal pain and altered bowel habit.

… it is tempting to speculate that GABAB receptor positive allosteric modulators may display efficacy in not only functional pain disorders of the bladder, but also of the bowel, through modulation of either central and peripheral GABAB receptors, or both

Positive allosteric modulators increase the activity of the receptor so in this case they are referring to increasing the activity of the GABAB receptor, reducing both bladder pain and gut pain.

This commentary and the original paper refer to ADX71441, which has been shown in animal studies to be “a novel positive allosteric modulator (PAM) of the GABAB receptor that has shown encouraging results in pre-clinical models of anxiety, pain, overactive bladder and alcohol addiction.”

We know GABA eases anxiety and pain and is extremely beneficial when it comes to alcohol and other addictions. In a recent blog post I shared how PharmaGABA eases physical anxiety in a young man who has recently given up Adderall, alcohol and nicotine.

And given that depression, anxiety and stress is higher in women with urinary incontinence it makes sense that an amino acid such as GABA may also help ease some of the symptoms of bladder pain syndrome when low GABA is a factor.

Depending on the root cause/s it’s likely addressing low serotonin, low endorphins and low vitamin D may play a role too. Of course, a full functional medicine and nutritional work up and review of diet is key too. Bladder dysfunction is seen in up to one third of celiac patients. This can cause leaky gut and nutritional deficiencies leading to low levels of neurotransmitters such a GABA and serotonin. Dietary oxalates can often be a factor with bladder issues and pain.

Considering all of this in conjunction with learning from/working with a pelvic floor physical therapist is key.  I highly recommend someone like Isa Herrera, MSPT, CSCS who hosts online masterclass training sessions for those with pelvic health issues. Her next series airs online mid-February and you can learn more and register here.

Here are some related blog posts that you may find helpful:

In case you’re new to GABA you can read more about it here: GABA for the physical-tension and stiff-and-tense-muscles type of anxiety.

The supplements blog lists GABA products I use with clients and recommend to those in my community.

I’m proposing that there is a place for doing a trial of the amino acid GABA (as a supplement) to help with bladder pain/interstitial cystitis and urgency, especially when there are symptoms of low GABA. If GABA helps to ease the visceral pain caused by IBS/SIBO, it may also help with bladder pain.

Have you observed less bladder pain when using GABA for easing physical symptoms of low GABA anxiety (stiff and tense muscles, overwhelm, lying awake tensely at night, anxious and using alcohol to self-medicate in order to calm down)?

Have you noticed any reduction in bladder urgency when using GABA for anxiety?

Do you also have IBS pain or SIBO (small intestinal bacterial overgrowth) pain that is eased by GABA?

Have the following helped: going gluten-free, lowering oxalates and/or working with a pelvic floor physical therapist?

If you’re a practitioner have you made any of these observations?

Please do share in the comments below and let me know if you found this helpful, what else has helped you or if you have questions.

How to address rectal spasms with GABA, pelvic floor work, gluten removal and squats

By Trudy Scott 43 Comments

Last week I wrote about proctalgia fugax, a condition that leads to rectal spasms and sharp fleeting pain in the lower rectum or anus, often described as excruciating and agonizing. Proctalgia fugax actually means anal pain of unknown cause but I am seriously questioning this definition because as you’ll see below there are a number of possible root causes!

I have experienced this horrible pain and was not willing to use medications. Instead, because I could find no other solutions, I experimented with sublingual GABA during an episode and then figured out how to prevent a spasm at the first hint of pain.  You can read all the details on this blog: How GABA eases agonizing rectal pain and spasms in under 2 minutes

I promised to share part 2 with some root causes and other solutions but this article has grown because of all the wonderful feedback on the above blog. I’ve gathered some of it here as additional resources.

What is the pain like?

Here are some additional descriptions of the pain (sharing here so others can relate and feel comforted that this is not something weird):

  • horrible, shooting pain up the lower rectum/spine area
  • I have had this issue since I was about 45 (I’m now 60) at least a few times per year. It lasts usually 15 to 30 minutes and is extremely painful.
  • I have had this pretty much all my life. More common with my period and the spasm lasts for close to 1/2 hour or so. Very deep aching pain.
  • It stops me in my tracks. The pain is so bad sometimes I can’t breathe. It’s scary.

For some people the fear of having a spasm when out and about is extremely traumatic:

It seems no one in the mainstream medical field is concerned about it. It may be physically harmless but I know many people on other forums who live in constant fear of an attack – especially publicly. It is far from psychologically harmless.

I loved all the feedback: pleased to find out there is a name for it and feel comforted to know you’re not alone. Many have been worried and embarrassed to ask for help. And across the board you are all very interested in experimenting with GABA (or theanine or taurine) to see if it helps reduce or eliminate the spasms in the moment.

This GABA approach is a good one because it helps ease the pain and spasms and because stress is a common underlying factor.

Positive feedback about GABA helping

I am pleased to get some positive feedback that GABA is helping:

I used to get these right before my period – hormonally related for me. Interestingly, I have been taking Pharmagaba to help me sleep better and to help me relax…noticed that I haven’t had one of these “butt cramps” as I call them, in months.

And this wonderful result from someone else:

There were times I literally had to sleep in the tub for 5 hours at a time and keep refilling it hot water. Most excruciating pain I’ve ever had and I’ve birthed a child naturally! I’m taking GABA for other reasons and after reading this (facebook post), I realize I haven’t had this since!

Concerns about using GABA

A few of you had concerns about using GABA – for example: GABA causes palpitations for me but I will seriously consider trying it.

I wouldn’t use GABA if it causes palpitations or I would at least experiment with super small amounts. I mentioned I’ve used up to 500mg – for many people this is too much and even 100mg may help. Taurine may be an option too. If you can’t tolerate GABA or taurine the next section covers some other options and how to address some of the possible root causes.

And someone shared that when she took GABA in the past for anxiety it really seemed to make her more anxious:

Since I did not have the expected result for anxiety, I wonder if it would not be the best choice for me in this situation either . . . I would like to use something which works quickly, so the sublingual option would have been appealing. I have used l-theanine with good results (for anxiety) and have never tried taurine before.

I would not recommend GABA for someone who gets more anxious with it. When something does work, like theanine, I’d go with that approach. Or I would consider a very small dose of GABA and build up slowly.

There are some common patterns

When looking at common patterns many who responded on the GABA blog:

Medications for relief

Many find relief with medications but side-effects always need to be considered and it makes the most sense to get to the root causes and address them. Here are some mentioned:

Addressing tight pelvic floor muscles and stress

We always want to get to the root causes of an issue and that is the most logical step. I reached out to the practitioners in my community to ask them how they help their clients and patients with this and what approaches they have used to end the spasm and pain. My colleague, Jessica Drummond, nutritionist and physical therapist, and an expert on female pelvic pain and women’s health, shares this advice:

For women with proctalgia fugax, the acute rectal spasm can come at any time unexpectedly. Usually, this is a sign that your pelvic floor muscles are tight and need to be relaxed. Avoid doing Kegel exercises, and see a physical therapist who is a pelvic floor specialist in order to release the muscles of your pelvic floor.

Additionally, it’s important to be sure that you’re finding time each day to fully relax, breathe deeply, and receive support from your family or friends. Often women with pelvic floor muscle spasm feel stressed or a lack of safety in their lives and bodies. So, working with a skilled professional to address your stress is key.

Lorraine shared these wonderful results with her pelvic floor therapy (on the GABA blog) and how much it’s been helping her:

Anxiety or stressful times was a huge trigger (I am still pretty type A) and I finally learned one reason among many that stress triggers it. My naturopathic doctor sent me to see the ‘guru’ in pelvic floor therapy–Caroline Allen in Ottawa. I suffered for years with anxiety and did not realize that I was still constantly holding my tummy in as an old habit to stress even now that I have overcome my anxiety disorder. She taught me how to relax the core which was a challenge at first and required much conscious thought–those muscles had many years of training to stay tight. I was also breathing incorrectly and she showed me that when our breathing is incorrect, our diaphragm is tight and then it pulls up and tightens the entire pelvic floor. I can often prevent or significantly decrease the severity of an attack by reminding myself to relax certain key muscles and breathing into the pelvic floor.

Gluten sensitivity, other food sensitivities and functional imbalances

Jessica also shares what can worsen pelvic floor function:

You may have nutrient deficiencies or [gluten or other] food sensitivities that can worsen your pelvic floor muscle function. And, if you have IBS or constipation that should be addressed by a nutrition professional who specializes in digestive or pelvic health.

Here is some of the feedback I received on the GABA blog, observing links to gluten sensitivity, other food sensitivities and functional imbalances:

  • Gluten sensitivity
    • I found that once I eliminated gluten from my diet, this almost eliminated the problem.
  • Other food sensitivities – keeping a food-stress-spasm log will help you figure this out
    • We have found a sensitivity to corn, coconut, and nightshades and eating these brings on an attack. I suspect gluten as well but don’t always get an attack the way corn will
    • Food too high in phytic acid is a huge trigger for me…I avoid nuts like the plague
    • I do have gluten intolerance, and have been gluten free since 2009. I also stay away from dairy, all grains, and eggs. Recently I went off of all nightshades and on a lectin free diet. I haven’t seen any difference yet, and it has been over a month, but then again I haven’t had a spasm lately either. Not sure if that is a coincidence or not.
    • I have discovered that the following foods bring it on the next day: gluten, onions, citrus, especially orange juice, and black tea. Staying away from these foods has made a huge difference, but I still get episodes, which makes me think there’s another trigger I haven’t discovered
  • Any functional imbalance
    • I’ve recently been seeing a new naturopathic doctor who addressed SIBO, hormone imbalance as well as a stubborn parasite. My attacks most often occurred in correlation with constipation, digestive upset and ovulation pain (I had low zinc and low progesterone). Addressing all three factors has helped.

Other possible factors that should be considered: low magnesium, low potassium, low serotonin, low vitamin D, low zinc and dehydration, and look at drug-induced nutrient depletions from the BCP, fluroquinolones and proton pump inhibitors.

Jessica provides a comprehensive overview in this article: Physical Therapy and Nutrition: A Powerful Combination To Heal Pelvic Pain. It’s written for health professionals but is an excellent overview for anyone.

Some other possible solutions

I received so much wonderful feedback on the GABA blog that I’ve gathered these other possible solutions into a list:

  • Skullcap and valerian for mild symptoms
  • Designs for Health Gastromend, a product that is healing for entire GI tract helps in 15 minutes. Drinking Aloe juice may be helping
  • Sitting on the toilet and pushing down like with a bowel movement [this doesn’t feel good when I do it] or sitting on my foot to apply upward pressure before the spasm gets to deep will generally shorten the duration. I have found that stretching and holding the stretch for a few minutes will ease the intensity and duration of the spasm.
  • Nothing seems to help me except for a really hot heating pad. It usually takes about 20 minutes or a little longer for the spasms to go away

Squats, reflexology and downward dog for immediate relief

I also received these solutions that provide immediate relief while you’re figuring out and addressing the bigger root causes:

  • My gastroenterogist recommended going into a deep squat when the spasm starts. I tried and it worked!
  • I rub the inner ankle area (above the bone) in an upward motion – both sides. I rub as hard as I can. It takes a few minutes of rubbing but the pain reduces almost immediately. I went to a foot reflexologist and she said that this area relates to the rectum.
  • Downward dog yoga pose

I appreciate all the wonderful feedback on the GABA blog and the opportunity to share this so more of us get answers more quickly! Too often we think it’s just us but I encourage seeking solutions no matter what weird quirks we think we have!

I have one more article to share on the topic so stay tuned for part 3 with an exercise that strengthens the pelvic area and reverses rectal spasms.

Feel free to share what’s worked for you, what your possible triggers are and if GABA or any of these approaches resonate with you.

How GABA eases agonizing rectal pain and spasms in under 2 minutes

By Trudy Scott 188 Comments

Proctalgia fugax is described as a condition that leads to rectal spasms and sharp fleeting pain in the lower rectum or anus. In some people it can be more than fleeting and is often described as excruciating and agonizing.  

This paper describing proctalgia fugax shares how this pain can

recur over weeks, is localized to the anus or lower rectum, and can last from seconds to several minutes with no pain between episodes. There is no diurnal variation. There are numerous precipitants [preceding factors] including sexual activity, stress, constipation, defecation and menstruation, although the condition can occur without a trigger.

Although the cause of proctalgia fugax is unclear, spasm of the anal sphincter is commonly implicated. The condition may be more likely to occur after sclerotherapy for hemorrhoids and vaginal hysterectomy. There are also associations with other functional pathologies, such as irritable bowel syndrome and anxiety.

My story

I have experienced this awful anal sphincter spasm and pain myself so I want to shine some light on this condition and offer the simplest and most effective solution: oral and sublingual GABA. It works to completely eliminate the pain in 1-2 minutes! And it can also be used to prevent a full-on spasm if you catch it in advance. More about this below.

Let me first share my story so you can relate to the pain. I started to experience this a few years ago. It was right after my aunt died from rectal cancer and my immediate thought was that I was dying of cancer. That’s how bad the pain was. It’s like nothing I’ve ever experienced and I’ve had some pretty bad pain experiences: shingles, a tick bite headache, ice-pick headaches from a neck injury and poking my eye on a tree-branch while hiking.

For me, since it initially used to happen during the night, it felt like I was in bad dream and was lying somewhere injured and in agony. I would half wake-up moaning in pain, not quite grasping how the pain I was feeling could be so bad. Then I would come fully awake and feel the need to bear down (as in needing to have a bowel movement) but this would actually make it worse.

How do others describe the pain?

When I shared this paper on facebook one woman said her rectal pain and spasms last 20-30 minutes and is bad a childbirth.

Someone else shared that her husband “complained of feeling like a knitting needle was being driven through his anus.”

What do I think my triggers are?

I have not had sclerotherapy for hemorrhoids or a vaginal hysterectomy. I do have a history of anxiety and panic attacks (in my late 30s) and do have IBS/SIBO right now and I suspect that both low GABA and IBS/SIBO are my biggest root causes. I no longer have any anxiety but since I respond so well to GABA I assume my GABA levels are not optimal (likely due to the SIBO). I suspect exposure to hidden sources of gluten could also be a factor, and this could also affect my GABA levels.

Medications or heating pads as a solution?

I didn’t ever consider the conventional approaches which include: botox, benzodiazepines, SSRIs, Gabapentin, lidocaine, oral diltiazem, topical glyceryl nitrate, nerve blocks or salbutamol.

A warm bath has been reported to help but I was looking for a 1-2 minute fix (and less if possible). Once you’ve experienced this pain you’ll understand that you not imagine running a bath in the midst of a spasm and waiting to get in it.

Heating pads do also work but can take 20 minutes to take effect and that is simply too long for most people.

The first solution for in-the-moment relief (takes 2 to 12 minutes)

After the first episode I started searching online and because I didn’t know it was called proctalgia fugax I searched for “rectal cramp”, “rectal spasm”, “anal cramp” and came across forums with hundreds of women asking about it and describing their pain.

But no-one really had a solution and many had seen their doctors without much success. The best solution that many people use is 30-60 seconds of finger pressure (with the finger wrapped in toilet paper) in the anal sphincter during a spasm. Sometimes this is needed for up to 2-3 mins and sometimes doing this 2 or 3 times a few minutes apart is needed. Think about how you put pressure on a calf muscle spasm to stop the cramps. This works well but the agony can last for the entire 2 to 12 minutes (depending on how many times it has to be done).  Adding a small amount of arnica cream onto the toilet paper seems to helps too.  

How common is it?

It took more searching and reading and then I discovered what it was called. Once I found a name for it and started looking into I was surprised to see how common it is:

The prevalence of proctalgia fugax in the general population may be as high as 8%–18%. Many patients present to primary health care physicians and often do not require further consultation because the symptoms are fleeting. This condition is more common among women than among men, and usually affects patients between 30 and 60 years of age.

Although it’s more common among women I worked with a male client who experienced this. During one of his episodes, the pain was SO bad he actually passed out and hit his head on the bathroom floor.

The best solution for almost-immediate relief (takes 1 minute)

I know that GABA works amazing well for physical anxiety and stiff and tense muscles and I decided to try GABA in the midst of a spasm. It worked amazingly well and within 1 minute the terrible pain started to ease. It does need to be taken sublingually and I have found that 250mg to 500mg opened onto my tongue works best for me.

Each person would need to find the ideal amount for their needs but at night this should be a reasonable amount. During the day this could be too much and make you sleepy or too relaxed.

I’ve also used a combination of sublingual GABA and theanine with similar results.

I know GABA isn’t readily available everywhere so I did an experiment with taurine and found I needed more (at least 1000 mg) and it did take longer (2-3 minutes) to get relief, but it did work.

THE immediate solution for preventing the spasm

But I have now gotten to the point where I can nip it in the bud and prevent the spasm altogether – by taking sublingual GABA at the very first hint of an ache or twinge. I’ve been fortunate that when this does happen (about once a month and sometimes every 2 months) it’s around 8-11pm.

The long-term solutions for getting to the root cause/s?

We always want to get to the root cause of an issue and that is the next step. I reached out to the practitioners in my community to ask them how they help their clients and patients with this and what approaches they have used to end the spasm and pain. I will be sharing some of their solutions and how to get to some of the root causes in part 2.

UPDATE: Here is part 2 – How to address rectal spasms with GABA, pelvic floor work, gluten removal and squats

I’d love your feedback!

I’d love your feedback so I can learn what works, so we can all learn from each other and so others get answers quicker than I did.

Have you ever experienced this rectal pain and spasms? And what has worked for you?

I’d love to know if it is more common after sclerotherapy for hemorrhoids and vaginal hysterectomy? Have you had either? Or any surgery in the abdominal area?

Do you also have IBS/SIBO?  What about celiac disease or gluten sensitivity?

Do you currently have anxiety or mood issues or have a history of anxiety or mood issues?  How many low GABA and low serotonin symptoms do you have – here is the questionnaire  (a paper from 1965 mentions that patients with proctalgia fugax have been described as irritable, perfectionistic, meticulous, obsessional, tense, and anxious)

If you’ve tried GABA or these other approaches (or decide to try them) please come back and share.  Too many people don’t know about this and it needs to change!